Using Skype to Provide Articulation Therapy to people around the world

Following up the use of Skype for providing services. I had the opportunity to interview Marcus Little, a Canadian Speech and Language Pathologist that is providing articulation therapy through Skype to kids and adults around the globe.

Q: Marcus, please tell us how you provide services:

Marcus: Skype has transformed the way I deliver speech therapy to my clients. My private practice is no longer limited to a 50 KM radius around where I live but rather by how far the Internet can reach. I now am able to serve clients all over the world in countries such as Dubai, Cameroon, Australia, England, Ireland and of course Canada. Skype + Paypal + internet marketing has allowed me to grow my private practice without leaving my home.

Q: How do you spread the word?

My Skype clients come from two sources. The first source is people who find me on the Internet. Having a web presence that takes advantage of multimedia and social media is KEY. Clients find me through twitter, YouTube, and web searches. My second source is from my existing pool of clients that I see in person. I offer my in-person clients the opportunity to do virtual sessions and approximately 50% of them will give it a try. The ones that do rarely choose to go back to the traditional face-to-face model. There are so many benefits to be had if you are willing to give up your initial resistance to doing therapy this way.

Q: What are the benefits of using Skype to deliver therapy?

Marcus:

Cost savings: No travel for clients or practitioners saves money. Also, it eliminates the need to have a separate physical space for client appointments.

Time savings: Our time is limited. Travel time adds up quickly.

More flexibility: It is much easier to schedule sessions and adjust therapy times on the fly. People do not mind waiting 15 minutes at home nearly as much as 15 minutes in an office.

Service Remote Areas: Service can be delivered to remote areas as long as internet service is available.

Shorter sessions: It is easier to offer 15 minute sessions for kids who struggle with attention. People will not drive across town for a short session but will do it virtually since travel time is not involved..

More sessions: Shorter sessions mean more sessions for the client. This is key as I find the biggest gains are made between sessions by those clients who practice and work their home program.

Share resources easily: Any worksheets or informative web info is shared digitally with ease. This is much easier and more environmentally friendly than photocopying everything.

Share my Computer Screen: I can share what is on my screen with my client easily. This is how I do an assessment. I have an articulation assessment that I have made into a PowerPoint slide show. Skype allows me to share the screen with my clients so I can do my assessment.

Focus’s Attention: A monitor is a wonderful thing for focusing a child’s attention. Even shy kids have an easier time watching a monitor than watching your face in person. I also like the ability to put my face really close to the webcam to give the client a “JUMBO” in your face model. This really drives articulator placement home.

Kids like it: Kids are more at home and comfortable in front of a computer. It is much easier to meet a new person in the comfort and security of your home instead of going to some foreign environment. Once again this is good for shy clients or clients who are dealing with anxiety.

Q: Are there any drawbacks?

There are drawbacks to Skype therapy. No hands on-so doing tactile therapy like PROMPT is out. It is not good for toddlers and preschool clients as they may lack attention skills required to sit in front of monitor. It is however, a good fit for most school aged clients and adults though.

Skype is a technology that relies on computers, networks and the internet to work. It is only as strong as its weakest link. A clinician has to know when to pull the plug on a session when things are unworkable. This happens infrequently but does happen. I have gotten much better at trouble shooting the situation and resolving problems fast. The majority of the time the video quality of the call will drop because someone else in the household is using the Internet over Wi-Fi causing the slowdown. That is the first place I look when having quality issues. Once the offender gets off the internet the image quality improves.

The Skype interface itself has become much more sophisticated in helping trouble shoot bad connections. Skype has the ability to help trouble shoot the computer, speakers, microphone, webcam, and internet connections. Skype also installs easily and walks people through installation process efficiently. The technology is definitely becoming more user friendly.

Q: Why are you so pumped about Speech Therapy using Skype?

I just experienced one of the most amazing months of my life. My entire family spent a month in Sunny Orlando Florida while my home province of Ontario (and most of the United States was hammered by winter storms.) I was able to maintain a visit schedule with my private clients while being away. Service delivery was seamless. The ability to jump in a swimming pool with my kids between clients was priceless. It was pure heaven. So much so that both my wife and I seriously considered moving down to Orlando for good.

The biggest obstacle to Skype being used more frequently is people’s reluctance to change. I like to compare this to my experience with early ATM machines. I remember a time when I would rather wait in line to hand my money to a real person. How things have changed. Now I would never wait in a line unless I absolutely had to. Getting people to try it is the key. In my experience, those who have tried the service immediately see and appreciate the value of teletherapy using SKYPE. My advice to you is to try it – but prepare to be wowed.

About Marcus Little:

Marcus Little is a Canadian SLP who is the person behind TheSpeechPathWay.com. He has a passion for delivering highly effective speech therapy service using Skype. He is also constantly evolving a methodology for developing “automaticity” of speech sound production via high repetition drillwork that focuses on developing the speed of the productions. He is dedicated to training parents to effectively implement a systematic homework program that yields results in less time.

I began telepractice on the Big Island using SKYPE last year. I drive 540 miles in a four day period which can get pretty darn tiring! It is a wonderful way to see those kids should they cancel (or I have to) and still get the numbers that my agency likes to see…I actually think I get more accomplished using this approach and kids love seeing themselves on the screen! Mahalo for sharing this! With the gas prices going up, I am sure I am going to be using this way of delivering my services even more! ALOHA! ~Genie, SLP of 34 years

That is great to hear you having such success working with your clients virtually. There is so many benefits to this type of therapy. I would love to connect with you on SKYPE to swap stories about what is working and what is not.

SKYPE has the option to share the screen . I will bring up PDF files or DOC files ahead of time and have them ready to go. During the course of a session I can share the workpage with my client to work on the drill sheets.

In our facilty, SKYPE is not considered secrure for delivery of speech telepractice and is not allowed. A recent post by Privacy International (https://www.privacyinternational.org/article/skype-called-answer-mounting-security-concerns) higlights why SKYPE is a problem. It does not meet confidentiality requirements. SKYPE does have some scrutiny features, allows sign in not using full names and other features. However these are not evident to most users. Also, SKYPE does not inform users when their account has been signed into from another location. By not receiving any notification an imposter who has obtained your information can be signed into your account from somewhere without you ever knowing. That person can see your contact list and your chat messages – in real time. A user would never, ever know
This raises serious concerns about the use of SKYPE for speech telepractice and is not recommended practice at this time.

Hi Michael. Can you share with everyone what you use for delivering teletherapy. If there is a better solution, we all need to know about it. The thing I like best about SKYPE is the constant updating and refining of their product. I have never had any issue with the level of security being provided or have had any incidents. The video and audio quality is beyond anything I have been willing to pay for barring spending several thousand dollars on a dedicated teleconferencing solution. There is always the possibility of a better product out there. I guess the real question is what do you recomend people use that is a more secure alternative that has equivalent audio and video quality.

I doubt most people using the internet today worry about the above-stated privacy concerns on Skype–many of them use Skype for personal reasons, where they could experience the same privacy breaches which Michael Towey describes as possible . I’m not sure why the privacy issue might overshadow the possible benefits for some people…, everything has its risks (including the risk of getting hit by a car, while traveling to a therapy appointment). We all weigh risks and benefits of what we do in our daily lives, and should make our own decisions about what risks we want to take. Information is good, but ultimately the decision needs to be with the user.

Hi Kristy,
Most oof my clients are paying out of pocket or have private insurance that offers some coverage. In Canada we do not have the same billing system you have in the US. Hopefully your health care will allow skype sessions to be billed in the near future. The cost effective nature of teletherapy will be more and more appealing as finacial concerns continue to grow.

Thank you Marcus for sharing your expertise! I work at an international school in Asia and have just begun to continue to serve students who have moved away to other countries via Skype. I love the idea of using the screen-share option with an artic on powerpoint, thanks!

Hi Marcus. I find we are on the same page on mass productions, frequency of service, and speed. My therapy, as I am sure with yours, is significantly less, months vs years. As you clearly state, there is a need to start slow using precision, but then the speed is a key element to carryover and natural speech. I too use Skype and my youngest clients are four. Because I use the speedy speech model, the 8-10 minutes are perfect for attention and focus not only for the young kids, but for older kids and adults as well. The privacy issues are noted, and my client’s are aware and want to proceed. They love the Skyping for all the reasons listed. You have a great site and information!

Marcus would you be available (for a fee) to set me up
from start to finish? I work in a school, a private
clinic and in home (clients). Besides having my C’s are there
additional certifications needed? I am interested in
international therapy. I am particularly interested
in Dubai, and the United Arab Emirates.

SKYPE should be compensating you for helping
promote their service. I have a SKYPE Id., perhaps
you can SKYPE me one on one.

About GeekSLP

GeekSLP is a place where speech-language-pathologists can learn about the latest news related to iPad apps for speech therapy. GeekSLP is written by Barbara Fernandes, a speech-language-pathologist with over 50 apps published on the app store. Barbara has presented around the world on the topic and is one of the most respected experts in exploring apps for speech and language.